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EU Rule Forbidding Language Tests for Foreign Doctors Costs Lives

Philip Mackenzie-Holland 21.04.2010 11:56
"Communication is uital" say doctors.

"Communication is uital" say doctors.




Ministers neglected the safety of the British people by their failure to ensure foreign doctors working out-of-hours could speak English properly, said MPs recently.

It was wrong that Britain was sticking rigidly to EU rules which outlaw checks on overseas GPs' language skills - while France flouted them, said the MPs in a damning report.

The Commons health select committee also poured scorn on the Government for agreeing to GPs' demands for a lucrative contract which makes it too easy for them to opt out of responsibility for out-of-hours care.

This has forced the NHS to bring in doctors from abroad.

The General Medical Council, which regulates doctors, has met Health Secretary Andy Burnham to request an end to the ban on language tests but was told that disobeying with the directive would end in fines from Brussels.

The MPs concluded: 'The GMC informed us that the situation in France was different: there, the regulator undertook language tests within the remit of the EU directive.

'If the GMC had been able to check the language skills and clinical competence of European doctors wishing to practice as GPs, lives might have been saved.'

It added that employing 'European locums who have inadequate English and/or general practice expertise has led to poor care and the deaths of patients'.

The report comes days after it was revealed that a hospital in Oxford was having to send staff on English lessons because 70 different nationalities were at work there.

An inquest in February criticised the current out-of-hours arrangements following the death of patient David Gray in Cambridgeshire in 2008.

He was killed by exhausted German doctor Daniel Ubani who administered ten times the normal dose of diamorphine.

The GMC is prevented from checking doctors' English under a European directive, which says to do so would hamper the free movement of people.

Ministers say letting the GMC to carry out such checks would land them with a huge fine from the EU - and that there is no chance to renegotiate the directive until 2012.

However, primary care trusts have a legal duty to check language skills - but many of them do not do so, as the case of Dr Ubani showed.

His poor English meant he was refused work by the NHS in West Yorkshire - but was later accepted in Cornwall.

The MPs said it was shocking that no one at Cornwall's Primary Care Trust had been disciplined for failing to check language competency.

The committee's report said that 'as a matter of extreme urgency', ministers should seek to get the directive changed 'to enable the GMC to test the clinical competence of doctors and undertake systematic testing of language skills so that everything possible is done to lessen, as soon as possible, the risks of employing another unsuitably trained or inexperienced doctor in out-of-hours services'.

In a stinging attack on the GPs' contract, which allowed more than 90 per cent to opt out of responsibility for patients out of hours, the committee said: 'It has some serious weaknesses, in particular in the use of [ European Economic Area] doctors and the failure to check their language skills and clinical competence, which led to the killing of a patient, Mr Gray, by Dr Ubani, a German locum.'

It added: 'The Department of Health showed little regard to securing value for money for taxpayers when they negotiated the out-of-hours GP reforms in 2004.

Even Health Minister Mike O'Brien admitted to the committee that GPs had 'got the best deal they ever had from that 2004 contract and since then we have, in a sense, been recovering'.

Patients' Association director Katherine Murphy said: 'If France can implement a more rigorous system, so can we.

'If the Department of Health don't think we can then they need to explain why. Transparency is vital.'

A spokesman for the Department of Health said: 'There is a legal obligation on a PCT to refuse to admit a doctor where the PCT is not satisfied that the doctor has the necessary knowledge of English.'

Tory health spokesman Mark Simmonds said: 'This report highlights the significant failures of Labour's out-of-hours system.'



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